Virus infections of the respiratory tract cytopathologic and clinical analysis.

Thirty-three cases of respiratory tract virus infections diagnosed cytologically are reviewed. The clinical and demographic data are presented and correlated with an analysis of the cytologic findings. Herpes virus was the most common infection. It occurred in patients with other severe medical problems and had little apparent effect on the clinical outcome of any particular case. Quantitative and qualitative cytologic findings did not correlate with the severity of the herpetic infection. The virus was isolated in culture in only one of 21 cases of Herpes virus infection. Cases in the later part of the study indicate an increasing incidence or recognition of the infection in the respiratory tract. In this series there was a clustering of Herpes virus cases in relation to date of admission and hospitalization in respiratory intensive care. Cytomegalovirus infection was recognized in four cases. This infection occurs in the immune suppressed patient and can be made reliably from cytologic findings. Smears must be screened thoroughly and carefully as the characteristic inclusion is seen in only a rare cell. Bronchial brushing specimens are the most useful. The disease should not be fatal if the level of immune suppression can be manipulated and the patients basic medical problem is not too severe. Cytologic findings contribute little information to tjor medical problems and the adenovirus infection was incidental. Thy cytologic findings in some cases may be non-specific since antibody studies and culteral confirmation are lacking in these cases.